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Call for regulated paid kidney donation

People should be paid £28,000 to be a kidney donor, claims expert

Adrian O'Dowd

Wednesday, 03 August 2011

People who agree to donate a kidney should be paid under a carefully regulated system to try and address the severe shortage of organs available, according to a personal view article published online today by the BMJ.

The BMA, however, has strongly rejected the idea and called for a system of presumed consent for donation with safeguards.

In the BMJ article Sue Rabbitt Roff, a senior research fellow at the Department of Medical Sociology at University of Dundee, says that it is time to explore “regulated paid provision” for live kidneys under strict rules that guarantee access and equity.

Ms Roff wants a system in which the standards of pre and post operative care would be as good as they are now for kidney donors in the UK, and where the standard payment would be equivalent to the average UK annual income of around £28,000.

This “would be an incentive across most income levels for those who wanted to do a kind deed and make enough money to, for instance, pay off university loans,” says the article.

Three people on the kidney transplant list in the UK die every day and thousands more attend dialysis units, waiting for a transplant.

Ms Roff said there needed to a public debate on “regulated paid provision” for live kidneys and explained that a regulated system would not resemble the illegal market that currently exists in several countries where poor people are exploited.

Demand for kidney transplantation would only increase, she argued, because the number of people with diabetes and high blood pressure was rising.

In addition, “the level of donation of both deceased and living kidneys has never kept pace with the need, and is plateaued at around 2,000 a year in the UK”. 

Ms Roff concluded: “We need to extend our thinking beyond opt in and opt out to looking at how we can make it possible for those who wish to do so to express their autonomy in the same way as current donors are encouraged to do by making available a healthy kidney for a fee that is not exploitative.”

Dr Tony Calland, chairman of the BMA’s medical ethics committee, said: “The BMA would not support payment for donating organs. We believe that one of the best ways to increase organ donation is to move to a system of presumed consent with safeguards – this would have to be supported by the public and be preceded by a high profile public awareness campaign. 

“Organ donation should be altruistic and based on clinical need. Living kidney donation carries a small but significant health risk. Introducing payment could lead to donors feeling compelled to take these risks, contrary to their better judgement, because of their financial situation.”

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